LIDOCAINE 2.5%/PRILOCAINE 2.5% KIT,TOP (13450) VA PRODUCT (50.68)

Name	Value
NAME	LIDOCAINE 2.5%/PRILOCAINE 2.5% KIT,TOP
VA GENERIC NAME	LIDOCAINE/PRILOCAINE
DOSAGE FORM	CREAM,TOP
ACTIVE INGREDIENTS	PRILOCAINE STRENGTH: 2.5 UNITS: % LIDOCAINE STRENGTH: 2.5 UNITS: %
NATIONAL FORMULARY NAME	LIDOCAINE/PRILOCAINE CREAM,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	LIDOCAINE 2.5%/PRILOCAINE 2.5% TOP KIT
VA PRODUCT IDENTIFIER	L0240
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4013815
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE